| NPI | 1861558785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD433806) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT186415) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-11-23 |